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29 Progressive familial intrahepatic cholestasis Type 3 is often similar in clinical presentation and histopathology to small duct PSC

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For these individuals, vitamin B12 injections are often the most effective way to restore healthy B12 levels because they bypass the digestive system entirely, delivering the vitamin directly into the bloodstream for maximum absorption (around 95% compared to 25-50% for oral supplements)
This suggests that after H 2 O 2 induction, FOXO4 facilitated Leydig cell senescence while maintaining the viability of senescent cells by repressing their apoptotic response
